Denise Grocke

The Effect of Music Therapy on Anxiety in Patients who are Terminally Ill

BACKGROUND The literature supporting the use of music therapy in palliative care is growing. However, the number of quantitative research studies investigating the use of music therapy in palliative care, and specifically anxiety, is limited. OBJECTIVE The aim of this research project was to examine the effectiveness of a single music therapy session in reducing anxiety for terminally ill patients. DESIGN A randomized-controlled design was implemented and the following hypotheses tested. There will be a significant difference between the experimental and control groups on anxiety levels as demonstrated by the anxiety measurement of the Edmonton Symptom Assessment System (ESAS), and heart rate. The experimental group received a single music therapy intervention and the control group received a volunteer visit. SETTING/SUBJECTS Twenty-five participants with end-stage terminal disease receiving inpatient hospice services were recruited. RESULTS The first hypothesis was supported. Results demonstrated a significant reduction in anxiety for the experimental group on the anxiety measurement of the ESAS (p = 0.005). A post hoc analysis found significant reductions in other measurements on the ESAS in the experimental group, specifically pain (p = 0.019), tiredness (p = 0.024) and drowsiness (p = 0.018). The second hypothesis was not supported. CONCLUSIONS The study supports the use of music therapy to manage anxiety in terminally ill patients. Further studies are required to examine the effect of music therapy over a longer time period, as well as addressing other symptom issues.

Individual Music Therapy for Mental Health Care Clients with Low Therapy Motivation: Multicentre Randomised Controlled Trial

Background: Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies. Method: This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71% were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point. Results: MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01). Conclusion: Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation.

Effect of Singing on Respiratory Function, Voice, and Mood After Quadriplegia: A Randomized Controlled Trial

OBJECTIVE To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia. DESIGN Randomized controlled trial. SETTING Large, university-affiliated public hospital, Victoria, Australia. PARTICIPANTS Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B). INTERVENTIONS The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention. MAIN OUTCOME MEASURES Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments. RESULTS The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017). CONCLUSIONS Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity.

Group music therapy for severe mental illness: a randomized embedded-experimental mixed methods study

Music therapy is an innovative approach to support people with severe mental illness (SMI). The aim of the study was to determine whether group music therapy (GMT) positively impacted on quality of life (QoL), social enrichment, self‐esteem, spirituality and psychiatric symptoms of participants with SMI and how they experienced the intervention.

Examining the relationship between self-reported mood management and music preferences of Australian teenagers

The influence of music on the moods and behaviour of young people has been much contested. Whilst some parties accuse the music industry of purposefully poisoning the minds of youth, others understand the relationship between teenagers and their music preferences as reciprocal. This article reports on an investigation examining what 111 Australian adolescents reported about changes in their mood before and after listening to self-selected genres of music. Most young people reported using music to improve their mood, particularly when their initial state was already positive; however when feeling sad or stressed, some young people reported a worsening mood. Correlational analysis revealed that whilst the distressed young people in this sample were more likely to prefer listening to angry music and have a preference for metal, they did not report a more negative effect on their mood than any other genre of music. The researchers conclude that mixed methodologies may be better suited for examining this complex phenomenon and for avoiding overly simplistic interpretations of data. Music therapists are encouraged to initiate dialogue with distressed young people in order to increase their consciousness about whether their mood improves or worsens when listening to self-selected music.

Is there a role for music therapy in the care of the severely mentally ill

Objective: The role of music therapy in psychiatric care in Australia is briefly traced from the early 1990s to the present. With the shift to community-based care, contemporary music therapy practice for the severely mentally ill is reappraised alongside the principles of the recovery model. Conclusions: Music therapy is a viable option within the creative arts therapies for enhancing quality of life in people with severe and enduring mental illness.

Music therapy for early cognitive rehabilitation post-childhood TBI: An intrinsic mixed methods case study

Abstract Objective: The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Method: Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. Results: The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. Conclusion: The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

The use of group descriptive phenomenology within a mixed methods study to understand the experience of music therapy for women with breast cancer

ABSTRACT Women living with breast cancer are faced with numerous challenges that have the potential to challenge their coping resources. However, positive benefits have been attributed to participation in psychosocial therapy groups. Music interventions used therapeutically within the context of music therapy demonstrate numerous positive benefits. Yet, little is written about the use of group music therapy for women with different stages of breast cancer. Moreover, there is a gap in understanding of the lived experience of women with breast cancer within a group context, for which data from descriptive phenomenology methods would fill. The purpose of this study was to understand the lived experience of music therapy for women with breast cancer; the author was both clinician/researcher. Four groups of women who were outpatients received six weekly music therapy sessions that incorporated various music therapy methods. Eighteen women at different stages of the disease spectrum took part in the study. The qualitative data were gathered through focus group interviews and were held post music therapy program. Twelve composite themes and one emergent theme evolved from the analysis. This study is one of only a few to examine a group music therapy experience for women with breast cancer. The study also contributes to the qualitative literature on group phenomenology and focus groups.

Re-Imaging in GIM Supervision

Re–imaging was first described by Bruscia as a process in which GIM therapists can uncover “vivid or intense feelings that seem unwarranted, alien, and somehow induced by the client” (Bruscia, 1998, p. 549). Two supervision sessions are described in which re–imaging was used for different purposes. The role of the supervisor is described and discussed in light of the traditional Bonny Method GIM session. Similarities and differences are explored.